scholarly journals Role of the Vaginal Microbiological Ecosystem and Cytokine Profile in the Promotion of Cervical Dysplasia: A Case–Control Study

2002 ◽  
Vol 10 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Kian Behbakht ◽  
Jennifer Friedman ◽  
Ira Heimler ◽  
Alla Aroutcheva ◽  
Jose Simoes ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Pap Smear ◽  
Cervical Dysplasia ◽  
Intraepithelial Neoplasia ◽  
Cytokine Profile ◽  
Gardnerella Vaginalis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Vaginal Smear ◽  
Pap Smears ◽  
Vaginal Lavage

Objective:To identify alterations in the cytokine profile and microbial ecosystem of the vagina in association with cervical dysplasia.Methods:Demographics, lifestyle variables and Papanicolau (Pap) smear results of subjects presenting to the same site for gynecologic complaints, obstetric visits or colposcopy were prospectively recorded. Vaginal smear for Gram stain, aerobic and anaerobic culture, pH, and wet mount and KOH examination forTrichomonas vaginalis,Gardnerella vaginalisand yeast organisms were performed. Vaginal lavage specimens were centrifuged, and the pellets and supernatants were assayed for human papillomavirus (HPV) by polymerase chain reaction and for cytokines interleukin (IL)-1ß IL-6, IL-10 and IL-12 by enzyme-linked immunosorbent assay (ELISA) respectively. Subjects with abnormal Pap smears underwent colposcopy and biopsy as indicated.Results: Of 51 patients, 32 were referred for colposcopy, 12 presented with gynecologic needs, and seven presented for obstetric visits. Median age was 24 years. Demographics did not differ significantly between the dysplasia and control groups except for a trend towards more sexual partners in the dysplasia group. Biopsies were performed in 81% (26/32) of patients presenting for colposcopy and 17 revealed cervical intraepithelial neoplasia. IL-1ß, IL-6, IL-10, and IL-12 levels were elevated in 63% (20/32), 38% (15/39), 4% (2/49), and 0% of samples respectively. Elevated vaginal lavage IL-1ß was associated with a 6.1 odds ratio (95% confidence interval 1.06–35) of cervical dysplasia. Alterations in other variables studied were not associated with cervical dysplasia.Conclusions: Elevated IL-1ß, possibly representing a complex host inflammatory response to multiple pathogens, was demonstrated in patients with cervical dysplasia.

scholarly journals Study of Trichomonas Vaginalis and Bacterial Vaginosis in Pap smear at a Tertiary Health Care Centre of Nepal

2020 ◽  
Vol 22 (1-2) ◽  
pp. 8-12
Author(s):  
Rakesh Pathak ◽  
P Pradhan ◽  
S Pudasaini ◽  
S Maharjan ◽  
AS Basnyat
Keyword(s):  
Bacterial Vaginosis ◽  
Trichomonas Vaginalis ◽  
Pap Smear ◽  
Disease Diagnosis ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Pap Smears ◽  
Vaginal Infections ◽  
Health Care Centre ◽  
Pap Screening

Cervical-vaginal infections are common problems in women of reproductive age presented with clinical features like white vaginal discharge, foul smelling odor and pruritis. Trichomonas vaginalis, Candidia and Gardnerella vaginalis are responsible for infectious vaginitis in creating anaerobic environment favoring Bacterial vaginosis caused by organisms like Gardnerella vaginalis, Chlamydia Trachomatis. Papanicolaou (Pap) smear examination is the simple, quick, painless routine screening test used for identification and detection of precancerous changes of uterine cervix as well as the cervico-vaginal infections resulting from bacterial, fungal and candida infections. The prime objective of the study was to identify the age wise distribution of cervical-vaginal infections and determine the frequency of Trichomonas vaginalis (TV) and Bacterial vaginosis (BV). A descriptive cross-sectional study was carried out in the Department of Pathology, Nepal Medical College and Teaching Hospital, Kathmandu. A total of 163 cases of TV and BV diagnosed on Pap smear were taken for the study. However, 564 Pap smears were received in the Department of Pathology for cytological evaluation during the study period. Once the smears were stained, the presence of clue cells, cannon balls and Trichomonas were observed. Out of 564 Pap smears received during the study period, 163 cases were of BV, TV and combined BV and TV. These 163 cases were included in our study. The age ranged from 20 to 65 years with majority (19.1%) of the women belonging to 35-39 years and the mean age was 38.18 ± 10.18 years. There were 97 cases (17.2%) of BV, 50 cases (8.9%) of TV and 16 cases (2.8%) of TV and BV co-infection. Bacterial vaginosis was the most predominant type of cervicovaginal infection followed by TV infection and TV and BV co-infections. Trichomonas vaginalis may create an environment favoring the development of BV. Pap screening could be the beneficial tool in early disease diagnosis and helps in preventing further complications by starting appropriate treatment.

scholarly journals Agents causing genital infections in routine cytological tests: frequency and characteristics of Papanicolaou smears

2022 ◽  
Vol 82 ◽  
Author(s):  
F. S. Carvalho ◽  
N. K. A. Porto ◽  
P. V. M. Azevedo ◽  
P. K. A. Magalhães ◽  
E. N. de Araújo ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Pap Smear ◽  
Clinical Pathology ◽  
Infectious Agent ◽  
Gardnerella Vaginalis ◽  
Pap Smears ◽  
Candida Spp ◽  
Pathology Laboratory ◽  
Genital Infections ◽  
Tract Infections

Abstract Urinary tract infections are responsible for most human infections, these are caused by bacteria, fungi, protozoa and associated microorganisms. The goal of this study was to determine the rate of vaginal infection-causing agents in routine cytological exams and also to evaluate the characteristics of positive tested Pap smears. A retrospective documental with descriptive aspect research was performed in a Clinical Pathology laboratory from Maceió-AL. The results of the Pap smears exams for Trichomonas vaginalis, Gardnerella vaginalis, Candida spp and HPV were arranged in a database as well as other data such as bacterial, protozoan, fungal and viral coinfections. The sample was composed by 18.645 women who have undergone Pap smear exams from 2013 to 2017. Of these analyzed exams, 27.4% in 2013, 10.9% in 2014, 10.6% in 2015, 15.2% in 2016 and 13.67% in 2017 were within normal range, however more than half of these exams presented some infections caused by unspecific or microbiological agents. By analyzing all the reports, 4.073 (21.84%) presented inflammations caused by some species of infectious agent with the following rate order: G. vaginalis and T. vaginalis. Furthermore, it was possible to confirm high rates of coinfection by and Candida spp. The rate of genital infections in this study highlights that there is a public health matter that must be controlled, which points a greater need for monitoring, guidance and actions towards greater awareness in order to prevent these problems.

scholarly journals Early Detection of Precursors of Cervical Cancer with Cervical Cytology and Visual Inspection of Cervix with Acetic Acid

2008 ◽  
Vol 47 (170) ◽  
Author(s):  
Pragya Dhaubhadel ◽  
A Vaidya ◽  
P Choudhary
Keyword(s):  
Early Detection ◽  
Visual Inspection ◽  
Pap Smear ◽  
Smoking Habit ◽  
Cervical Dysplasia ◽  
Intraepithelial Neoplasia ◽  
Maternity Hospital ◽  
Cervical Neoplasia ◽  
Intraepithelial Lesion ◽  
Age Of Marriage

A hospital-based, prospective study was done in 350 women of 20-50 years to compare VIA withPap smear for early detection of cervical dysplasia at Maternity Hospital, Thapathali, from May2004 to December 2004. Pap smear was taken from each woman followed by VIA. Women withpositive VIA and/or positive Pap smear were referred for colposcopy-directed cervical biopsy. Thevariables studied were age group, presenting complaint, age of marriage, parity, smoking habit andappearance of cervix.The incidence of positive VIA and Pap smear was 2.86 and 0.57 respectively. Pelvic pain was themost common presenting complaint. The majority of the women were married before 20 years ofage. All women with either positive VIA and/or Pap smear were of parity two or above. Therewas no significant association between smoking and positive VIA (P=0.699) or Pap smear (P=0.397).Approximately 36.57% of the women screened had abnormal looking cervix. There were two womenwith high grade intraepithelial lesion (HSIL) and both were VIA positive and this was statisticallysignificant (Fischer exact P=0.0007). Of the ten VIA positive women, on histopathological examinationsix showed chronic cervicitis, one acute cervicitis, one showed cervical intraepithelial neoplasia (CIN)II, one had normal finding and one was lost to follow up.VIA as a screening test for cervical neoplasia did not miss any lesion detected by Pap smear andconfirmed by cervical biopsy.Key words: cervical neoplasia, pap smear, visual inspection

scholarly journals Papillomavirus in cervicovaginal smears of women infected with human immunodefficiency virus

1995 ◽  
Vol 113 (6) ◽  
pp. 1009-1011 ◽  
Author(s):  
Edenilson Eduardo Galore ◽  
Maria José Cavaliere ◽  
Neuza Kasumi Shirata ◽  
Maria de Fátima Araújo
Keyword(s):  
Trichomonas Vaginalis ◽  
Intraepithelial Neoplasia ◽  
Gardnerella Vaginalis ◽  
Herpes Simplex Virus 1 ◽  
Candida Sp ◽  
Cytopathic Effects ◽  
Immunological Factors ◽  
Simplex Virus ◽  
Invasive Carcinomas ◽  
Hiv Seropositive

It has been described that women infected with the human immunodeffciency virus (HIV) present more frequent cytological abnormalities in cervicovaginal smears, generally related to infection by human papillomavirus (HPV). The present work is a study of cervicovaginal smears of 147 HIV-seropositive women submitted to routine gynecological examinations. The smears were stained by the Papanicolaou method. Cytopathic effects of HPV were found in 38 (25.8%) cases. Nuclear atypias of cervical intraepithelial neoplasia (CIN) were evident in 36 (24.5%) of these cases: 27 (18.4%), CIN I; 6 (4.0%), CIN II and 3 (2.0%) CIN III. Also 2 (1.4%) invasive carcinomas and one (0.7%) endocervical dysplasia were found. Other agents observed were: Candida sp, 19 (12.9%) cases, Gardnerella vaginalis, 19 (12.9%), Trichomonas vaginalis, 13 (8.4%), Chlamydia trachomatis 5 (3.4%), Mobiluncus sp 2 (1.4%) and Herpes simplex virus 1 (0.7%). This study emphasizes the high frequency of HPV/CIN cervicovaginal abnormalities in HIV-seropositive in our population. It is possible that immunological factors and sexual promiscuity are involved in this phenomenon.

Factors associated with regression of cervical dysplasia in adolescents: A retrospective study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5582-5582
Author(s):  
C. Chen ◽  
F. Campbell ◽  
J. Patruno ◽  
S. Kimmel ◽  
R. Boulay ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Pap Smear ◽  
Demographic Data ◽  
Cervical Dysplasia ◽  
Smoking History ◽  
Pap Smears ◽  
Factors Associated ◽  
Increased Risk ◽  
Chi Square Analysis

5582 Background: Sexually active adolescents have high rates of infection with human papilloma virus (HPV) and abnormal pap smears. They are considered a special population as they are likely to regress to normal cytology. The aim of our study was to identify factors associated with regression of cervical dysplasia in adolescents. Methods: We identified adolescent patients (aged 12–21 years) who had abnormal pap smears at the Center for Women's Medicine at Lehigh Valley Hospital in Allentown, PA, by CPT code from a database between Jan 2004 and Dec 2006. A chart review was performed to capture demographic data, cytology, smoking history, number of sexual partners, parity, race, contraceptive choice, use of barrier contraception. Chi-square analysis with logistic regression and multivariate analysis were used to identify factors associated with regression of cervical dysplasia. Results: Two-hundred two patients were identified. Mean age was 18.84 years (14–22 years). One hundred twenty-two (57.8%) were Hispanic, 71 (33.6%) Caucasian, and 16 (7.6%) Black. Fifty-two (24.6%) were pregnant at the time of diagnosis. Seventy-six (36%) were smokers. There were 125 (61.9%) cases of ASCUS, 33.7% (68 cases) LGSIL and 4.5% (9 cases) HGSIL on initial pap smear. One hundred eighteen (55.9%) patients had colposcopy, and of these, 32 (15.2%) had surgical intervention. Follow-up demonstrated that 72 (57.6%) patients had disease regression, 24 (19.2%) persistence and 29 (23.2%) progression. On multivariate analysis, patients who did not smoke were significantly more likely to show regression of cervical dysplasia on pap smear than women who smoked (OR 2.17, 95% CI 1.03–4.55, p = 0.039). Other factors were not statistically significant in predicting regression of cervical dysplasia. Conclusions: Adolescents who smoke were more likely to have persistent cervical dysplasia than non-smoking adolescents, putting smokers at an increased risk of advanced disease. We suggest that this subset have follow-up at shorter intervals and be enrolled in a smoking cessation program. No significant financial relationships to disclose.

scholarly journals Cumulative Impact of HIV and Multiple Concurrent Human Papillomavirus Infections on the Risk of Cervical Dysplasia

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
David H. Adler ◽  
Melissa Wallace ◽  
Thola Bennie ◽  
Beau Abar ◽  
Tracy L. Meiring ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Young Women ◽  
Pap Smear ◽  
Cervical Dysplasia ◽  
Pap Smears ◽  
Papillomavirus Infections ◽  
Cumulative Impact ◽  
Hiv Coinfection ◽  
Increased Risk ◽  
The Impact

Infection with HIV is known to increase the risk of cervical cancer. In addition, evidence suggests that concurrent infection with multiple human papillomavirus (HPV) genotypes increases the risk of cervical dysplasia more than infection with a single HPV genotype. However, the impact of the combination of HIV coinfection and presence of multiple concurrent HPV infections on the risk of cervical dysplasia is uncertain. We compared the results of HPV testing and Pap smears between HIV-infected and HIV-uninfected young women to assess the cumulative impact of these two conditions. We found that both HIV and the presence of multiple concurrent HPV infections are associated with increased risk of associated Pap smear abnormality and that the impact of these two risk factors may be additive.

scholarly journals Análise dos resultados do último laudo citopatológico de pacientes com Papanicolaou em atraso

2020 ◽  
Vol 11 (3) ◽  
Author(s):  
Nathanael De Souza Maciel ◽  
Francisco Jardsom Moura Luzia ◽  
Diego Da Silva Ferreira ◽  
Maria Charlianne de Lima Pereira Silva ◽  
Davide Carlos Joaquim ◽  
...  
Keyword(s):  
Trichomonas Vaginalis ◽  
Pap Smear ◽  
Gardnerella Vaginalis ◽  
Cervical Lesions ◽  
Papanicolaou Test ◽  
Pap Tests ◽  
Sexually Transmitted ◽  
Candida Sp ◽  
Infecciones De Transmisión Sexual

Objetivo: Analisar os resultados do último laudo citopatológico de pacientes com o exame Papanicolaou em atraso. Metodologia: Estudo documental, retrospectivo, com abordagem quantitativa, realizado no município de Redenção–CE. Foram explorados 660 prontuários de mulheres com idade entre 25 e 64 anos. Para análise foram utilizadas medidas de tendência central e frequências absolutas e relativas. Resultados: O número de mulheres que nunca haviam realizado o exame Papanicolaou foi de 44,7% e as que haviam realizado, mas estavam em atraso, foi de 55,3%. A presença de células metaplásicas foi menos frequente (38,6%). Entre agentes infecciosos, houve prevalência dos resultados sugestivos de Gardnerella vaginalis e Mobiluncus (14,9%), Cândida sp (3,9%) e Trichomonas vaginalis (1,1%).  Os laudos indicaram presença de alterações celulares pré-malignas e malignas. Conclusão: Esta análise poderá motivar a implementação da busca de pacientes com exame atrasado, especialmente das que apresentam alguma infecção sexualmente transmissível ou alteração celular pré-maligna ou maligna.Descritores: Neoplasias do Colo do Útero; Teste de Papanicolaou; Programas de Rastreamento; Atenção Primária à Saúde, Enfermagem.ANALYSIS OF THE RESULTS OF THE LAST CYTOPATHOLOGICAL EXAM OF PATIENTS WITH DELAYED PAP SMEARObjective: To analyze the results of the last cytopathological report of patients with delayed Pap smear. Methodology: Documentary, retrospective study with quantitative approach, conducted in the city of Redenção-CE, from April to September 2018. Were explored 660 medical records of women aged 25 to 64 years. For analysis, measures of central tendency and absolute and relative frequencies were used. Results: The number of women who had never had the Pap smear was 44,7%, and those who had been submitted but were delayed were 55,3%. The presence of metaplastic cells was less frequent (38,6%). Among infectious agents, there was a prevalence of suggestive results of Gardnerella vaginalis and Mobiluncus (14,9%), Candida sp (3,9%) and Trichomonas vaginalis (1,1%). The reports indicated the presence of premalignant and malignant cellular alterations. Conclusion: There are a large number of women with delayed Pap tests and a deficiency in the quality of the tests, indicated by the absence of metaplastic tissue. This should motivate the active search of patients to interrupt the chain of transmission of Sexually Transmitted Infections and to treat cervical lesions early, reducing the chances of progression.KEYWORDS: Uterine Cervical Neoplasms, Papanicolaou Test, Mass Screening, Primary Health Care, Nursing. ANÁLISIS DE LOS RESULTADOS DEL ÚLTIMO EXAMEN CITOPATOLÓGICO DE PACIENTES CON PAPANICOLAOU EN RETRASOObjetivo: Analizar resultados del último examen citopatológico de pacientes con Papanicolaou en retraso. Metodología: Estudio documental, retrospectivo, con enfoque cuantitativo, realizado en la ciudad de Redenção-CE, de abril a septiembre de 2018. Fueron explorados 660 prontuarios de mujeres de 25 a 64 años. Para el análisis, se utilizaron medidas de tendencia central, frecuencias absolutas y relativas. Resultados: El número de mujeres que nunca se habían hecho la prueba de Papanicolaou fue del 44,7%, y las que se sometieron, pero estában en retraso, fueron 55,3%. La presencia de células metaplásicas fue menos frecuente (38,6%). Entre los agentes infecciosos, hubo una prevalencia de resultados sugestivos de Gardnerella vaginalis y Mobiluncus (14,9%), Candida sp (3,9%) y Trichomonas vaginalis (1,1%). Los informes indicaron presencia de alteraciones celulares premalignas y malignas. Conclusión: Hoy una gran cantidad de mujeres con pruebas de Papanicolaou retrasadas y una deficiencia en la calidad de los exámenes, indicada por la ausencia de tejido metaplásico. Esto debería motivar la búsqueda activa de pacientes para interrumpir la cadena de transmisión de las infecciones de transmisión sexual y para tratar las lesiones cervicales temprano, reduciendo las posibilidades de progresión.PALABRAS-CLAVE: Neoplasias del Cuello Uterino, Prueba de Papanicolaou, Tamizaje Masivo, Atención Primaria de Salud, Enfermería.

scholarly journals Comparative study of pap smear and microbiological pattern in bacterial vaginosis

2018 ◽  
Vol 7 (3) ◽  
pp. 1039
Author(s):  
Girishma J. ◽  
Rupakala B. M. ◽  
Sunil Chavan
Keyword(s):  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Pap Smear ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Pap Smears ◽  
Gram Stain ◽  
Medical College ◽  
Gram Staining ◽  
Gynecology And Obstetrics

Background: Bacterial vaginosis is the most common cause of vaginal discharge among women in reproductive age group. It is characterized by an increased vaginal pH and loss of normal lactobacilli and overgrowth of anaerobes like Gardnerella vaginalis and other gram-negative rods. Purpose of this study is to compare the characteristics of pap smear and microbiological pattern in patients with abnormal vaginal discharge.Methods: The study was conducted in the Department of Gynecology and Obstetrics of Rajarajeswari Medical College and Hospital (RRMCH) Bangalore, India. All patients with vaginal discharge were included in the study. Vaginal discharge samples were sent to gram staining, culture and pap smear examination.Results: Of the 52 patients, 18 patients (34.6%) showed positive for bacterial vaginosis according to Nugent’s score. Of the 18 patients with positive Gram stains, 8 of them were positive for bacterial vaginosis according to pap’s smear (44%) and 10 had negative pap smears. In our study, of the 18 patients with positive Gram stains, 14 (77%) of them were positive for bacterial vaginosis according to culture.Conclusions: In the present study we found out that correlation of gram stain and pap smear was 44% whereas correlation of gram stain and culture was 77%. Hence, we conclude that gram stain and culture are preferred for the diagnosis of bacterial vaginosis rather than the pap smear evaluation.

Gardnerella vaginalis and Trichomonas vaginalis infections and the risk of persistence or progression of low-grade cervical intraepithelial neoplasia

2020 ◽  
Vol 216 (12) ◽  
pp. 153234
Author(s):  
Antonio Raffone ◽  
Antonio Travaglino ◽  
Antonio Angelino ◽  
Rosanna Esposito ◽  
Martina Pontillo ◽  
...  
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Trichomonas Vaginalis ◽  
Intraepithelial Neoplasia ◽  
Gardnerella Vaginalis ◽  
Low Grade

scholarly journals Enhanced Detection of Cervical Cancer and Precancer Through Use of Imaged Liquid-Based Cytology in Routine Cytology and HPV Cotesting

2018 ◽  
Vol 150 (5) ◽  
pp. 385-392 ◽  
Author(s):  
R Marshall Austin ◽  
Agnieszka Onisko ◽  
Chengquan Zhao
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Cervical Screening ◽  
Intraepithelial Neoplasia ◽  
Pap Smears ◽  
Adenocarcinoma In Situ ◽  
Hpv Testing ◽  
Liquid Based Cytology ◽  
Positive Results

AbstractObjectivesCervical screening strives to prevent cervical cancer (CxCa), minimizing morbidity and mortality. Most large US reports on cytology and human papillomavirus (HPV) cotesting of women aged 30 years and older are from one laboratory, which used conventional Papanicolaou (Pap) smears from 2003 to 2009.MethodsWe quantified detection of CxCa and precancer (cervical intraepithelial neoplasia 3/adenocarcinoma in situ [CIN3/AIS]) in 300,800 cotests at Magee Womens Hospital since 2005. Screening histories preceding CxCa and CIN3/AIS diagnoses were examined to assess the contribution of cytology and HPV testing. Cotesting utilized Food and Drug Administration-approved imaged liquid-based cytology (LBC) and from-the-vial HPV tests.ResultsLBC identified more women subsequently diagnosed with CxCa and CIN3/AIS than HPV testing. HPV-negative/cytology-positive results preceded 13.1% of CxCa and 7.2% of CIN3/AIS diagnoses.ConclusionsLBC enhanced cotesting detection of CxCa and CIN3/AIS to a greater extent than previously reported with conventional Pap smear and HPV cotesting.

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